Provider Demographics
NPI:1154406130
Name:SANFORD PUBLIC SCHOOLS
Entity type:Organization
Organization Name:SANFORD PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAIDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:719-274-5167
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:CO
Mailing Address - Zip Code:81151
Mailing Address - Country:US
Mailing Address - Phone:719-274-5167
Mailing Address - Fax:719-274-5830
Practice Address - Street 1:755 2ND ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:CO
Practice Address - Zip Code:81151
Practice Address - Country:US
Practice Address - Phone:719-274-5167
Practice Address - Fax:719-274-5830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO97438561Medicaid